Acne Depression: Is It Real? Is It Serious?
Acne vulgaris, a common skin disorder, was proven to cause significant psychological and psychosocial repercussions in 1955. Since these findings, measures have been taken to curb and prevent those effects. These measures have been successful to some degree, but the effects that acne has on a person’s mental health are much deeper than originally thought1. Too often these issues are overlooked and considered unimportant to those who have never felt the effects of having a disease that affects the way they present themselves to the world.
Acne Vulgaris In Teens
Most often, acne vulgaris appears in teens and pre-teens just before or during puberty. This of course is the time in life when they are most sensitive to any changes or modification to their body or appearance. During this time, they are undergoing social and physiological changes making them more psychologically vulnerable2 30-50% of teens experience serious psychological difficulties3 that are a result of acne. Some of these difficulties include managing emotions regarding their social interactions, body image and even sexuality in relation to the acne.
Being that acne most frequently manifests on the facial area in teens, rather than other more obscure areas that can be covered by clothing or long hair, it worsens issues with social consciousness and low self esteem in regards to body image. This brings about the psychosocial difficulties brought on by acne. Personal relationships with friends and family can become strained and even severed completely as the adolescent tries to deal with the appearance of acne4. Rather than dysphoria, depressio.n or anxiety, the first effect of acne that teen will exhibit is embarrassment5 This will lead to avoiding sports, parties, dances and other activities that teens would normally participate in. The lack of interaction and the feeling of alienation will often then lead to deep depression6.
Adult Onset Acne
For people who begin experiencing acne in their 20’s or later, the psychological effects can be just as bad and sometimes worse than adolescents experiencing the same thing. If a person with adult onset acne did not experience the disorder in their youth, they too may not have the tools to deal with such a change.
Oftentimes, the effects of such a change can be life altering and even devastating7. Adults who experience late onset acne more often contemplate suicide, feeling as though they have become devalued as a person in situations ranging from employment to personal and sexual relationships. In the instance of employment, it has been found that employers did indeed pass over candidates who had moderate to severe acne. Personal relationships can become strained, but in many of these cases it’s because of the acne sufferer’s sudden mood change and view of their own life8.
Severity Of Psychological Impact Versus Severity Of Acne
The odd part of the link between acne and it’s psychological impacts9 is the lack of symmetry between the severity of the two. Those with minor acne lesions in comparison to those with severe acne vulgaris, often times, reacted just as strongly to the effects on their appearance10 as did those with the more severe acne. At this point in their lives, while teens are dealing with the many changes in their body, they lack the coping mechanisms to deal with even one more.
In more mature acne sufferers, a lack of acne during their youth may have normalized their adolescence, but they are not equipped to deal with such a visible disease in adulthood. This could be the explanation to such extreme reactions to acne blemishes even when the severity is fairly mild. Each acne sufferer views their disorder just as seriously as the next11, albeit some conditions are far worse than others. Each subject experiences the same changes12 and has but few tools to deal with it.
Some Solutions For Mild To Moderate Acne Depression
There are many methods to treating acne for those who are not experiencing suicidal or anti-social behavior. From visiting the dermatologist and having the patience to wait for prescription medications to begin working to joining online forums dedicated to helping people with acne depression, support is available. Parents are often desperate and may find themselves asking “Does Proactive really work?” In some situations products like that might be a solution. But proper skin care routines, changes in diet and lifestyle and even learning that a good friend or a close family member is there for them are often enough to begin healing the psychological wounds of acne. Keeping a close eye on acne sufferers and their ability to cope with the disorder is tough. The effects of the disorder are very real and very serious and need to be addressed as such.
Dealing With Deep Acne Depression
Deep acne depression13 is a very serious and very dark depression. Those who suffer this depression are often withdrawn socially and have “given up” on normal life14. Doctors who encounter this type of depression often times will prescribe anti-depressant medication along with medication to help heal acne. So often though, it is seen that deep acne depression sufferers don’t make it to the doctor. They don’t want to leave their homes and especially don’t want to be seen in public.
Parents feel helpless and sometimes even apathetic, feeling that this is just a phase in their child’s life and it will soon pass. For these patients, help seems impossible and hope is non-existent. Unfortunately, this feeling of hopelessness is what can lead to thoughts of suicide among those who have acne.
Doctors, namely dermatologists, have been observing this type of depression for decades and still don’t have all the tools they need to support these patients and the even the sufferers they don’t see but know exist. Through psychological evaluations before many types of acne medications are prescribed, doctors are able to step in to try to help these patients, but what about the ones who aren’t able to visit a physician?
The only way to start helping all acne sufferers is to make the subject of acne depression more apparent to the general population. Acne education and support groups in schools and support groups and more online forums for adults must be implemented. In most cases, acne is not permanent and it is overall it is not a fatal disorder. Information is the number one way to reach those who have acne. Information, support, understanding and empathy are the best things that can be done at this time for anyone who has acne. Medications and counseling are of the utmost importance as well.
If you know someone who suffers from acne, talk to them. Be their friend and encourage them. Empathize with them and above all, recognize that their issues are real and serious. Acne depression doesn’t have to get to a point of being fatal. Just as the disorder of acne is non-fatal and temporary, this too shall pass, but only if it is recognized and addressed.
- Behnam B, Taheri R, Ghorbani R, Allameh P. Psychological impairments in the patients with acne. Indian J Dermatol. 2013 Jan-Feb;58(1):26-9. doi: 10.4103/0019-5154.105281. PubMed PMID: 23372208; PubMed Central PMCID: PMC3555368. Behnam B, Taheri R, Ghorbani R, Allameh P. Psychological impairments in the patients with acne. Indian J Dermatol. 2013 Jan-Feb;58(1):26-9.
- Behnam B, Taheri R, Ghorbani R, Allameh P. Psychological impairments in the patients with acne. Indian J Dermatol. 2013 Jan-Feb;58(1):26-9.
- Aktan S, Ozmen E, Sanli B. Anxiety, depression, and nature of acne vulgaris in adolescents. Int J Dermatol. 2000 May;39(5):354-7.
- Hull PR1, D’Arcy C. Acne, depression, and suicide. Dermatol Clin. 2005 Oct;23(4):665-74.
- Golchai J, Khani SH, Heidarzadeh A, Eshkevari SS, Alizade N, Eftekhari H. Comparison of anxiety and depression in patients with acne vulgaris and healthy individuals. Indian J Dermatol. 2010 Oct-Dec;55(4):352-4.
- Dunn LK, O’Neill JL, Feldman SR. Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders. Dermatol Online J. 2011 Jan 15;17(1):1.
- Fabbrocini G, Cacciapuoti S, Monfrecola G. A Qualitative Investigation of the Impact of Acne on Health-Related Quality of Life (HRQL): Development of a Conceptual Model. Dermatol Ther (Heidelb). 8(1):85-99.
- Dreno B, Bordet C, Seite S, Taieb C; ‘Registre Acné’ Dermatologists. Acne relapses: impact on quality of life and productivity. J Eur Acad Dermatol Venereol. 2019 May;33(5):937-943.
- Dreno B, Bagatin E, Blume-Peytavi U, Rocha M, Gollnick H. Female type of adult acne: Physiological and psychological considerations and management. J Dtsch Dermatol Ges. 2018 Oct;16(10):1185-1194.
- Revol O, Milliez N, Gerard D. Psychological impact of acne on 21st-century adolescents: decoding for better care. Br J Dermatol. 2015 Jul;172 Suppl 1:52-8.
- Magin P, Adams J, Heading G, Pond D, Smith W. Psychological sequelae of acne vulgaris: results of a qualitative study. Can Fam Physician. 2006 Aug 10;52(8):978-9. Epub 2006 Aug 10. PubMed PMID: 17273501; PubMed Central PMCID: PMC1781509. Magin P, Adams J, Heading G, Pond D, Smith W. Psychological sequelae of acne vulgaris: results of a qualitative study. Can Fam Physician. 2006 Aug 10;52(8):978-9.
- Wen L, Jiang G, Zhang X, Lai R, Wen X. Relationship between acne and psychological burden evaluated by ASLEC and HADS surveys in high school and college students from central China. Cell Biochem Biophys. 2015 Mar;71(2):1083-8.
- Acne can affect more than your skin | American Academy of Dermatology. Aad.org. 2019
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